Bile acid binding resins such as cholestyramine, colestipol
, or colesevelam adsorb and reduce bile acid absorption and may reduce the absorption, systemic exposure, and efficacy of OCALIVA.
One cohort received the combination of loperamide and budesonide, the second cohort received the combination of loperamide plus colestipol
, the third cohort received colestipol
plus loperamide as needed and the fourth cohort did not use any antidiarrheal drugs as mandatory prophylaxis but instead used a dose escalation during the first month of neratinib treatment.
Because a subset (approximately 28%) of patients with IBS-D have bile acid malabsorption, an empiric trial of a bile acid sequestrant could be considered for diarrheal symptoms based on evidence of efficacy in recent pilot studies (eg, cholestyramine, 9 g two to three times daily, colestipol
, 2 g once or twice daily, or colesevelam, 625 mg once or twice daily).
Currently available therapies are BASs like cholestyramine, colestipol
, and colesevelam.
([section][section]) Nonstatin lipid-lowering drugs included Niacin, Gemfibrozil, Fenofibric Acid, Clofibrate, Colesevelam, Colestipol
, Cholestyramine, and Cholestyramine/Sorbitol.
The BAS include colesevelam (Welchol, Daiichi Sankyo Inc, Tokyo, Japan), colestipol
(Colestid, Pfizer Inc, New York, New York), and cholestyramine (LoCholest, Warner Chilcott Inc, Rockaway, New Jersey; Prevalite, Upsher-Smith Laboratories, Maple Grove, Minnesota; and Questran, Par Pharmaceutical, Woodcliff Lake, New Jersey).
The weight loss drugs Orlistat or Olestra, and the cholesterol-lowering bile acid sequestrants Choletryamine, Colestipol
, and Colsevelam can block fat absorption, creating a potential for vitamin K deficiency since it is fat-soluble.
(iv) Bile acid sequestrants (which prevent fat absorption) such as cholestyramine, colestipol
, or colesevelam
Currently, there are six categories of antilipidemic drugs available in the market, namely, HMG-CoA reductase inhibitors (statins), for example, lovastatin; bile acid sequestrants (anion-exchange resins), for example, cholestyramine and colestipol
; fabric acid derivatives (fibrates), for example, clofibrate, gemfibrozil, fenofibrate, ciprofibrate, and bezafibrate; nicotinic acid, for example, niacin; cholesterol absorption inhibitors, for example, ezetimibe; and omega-3-fatty acids (fish oil), for example, Pulse .
Mean annual IMT change, mm Trial Medication Placebo Treatment PLAC II Pravastatin 0.068 0.059 KAPS Pravastatin 0.029 0.010 ASAP Simvastatin -- -0.009 PREVENT Amlodipine 0.011 -0.015 ASAP Atorvastatin -- -0.020 CLAS Colestipol
, niacin 0.010 -0.020 MARS Lovastatin 0.015 -0.028 VHAS Verapamil -- -0.028 AMAR Allicor 0.015 -0.022 NCT01743404 Inflaminat 0.062 -0.068 NCT01742000 Karinat 0.111 0.006 Trial Reference PLAC II Crouse III et al., 1995  KAPS J.
Bile-salt binding resins, such as colestipol
, lower cholesterol by preventing reabsorption of the bile salts from the intestine.
Bile acid sequestrants include cholestyramine (Prevalite, Questran), colesevelam (Welchol), and colestipol